Section A: Prior to referral, ask yourself these questions
- Have I assessed the child and documented my findings?
- Have I documented existing risk factors or issues?
- Is there any evidence of substance abuse, domestic abuse, mental illness, a chaotic lifestyle or missed appointments?
- Has a Common Assessment Framework (CAF) been followed?
- Has the situation been discussed with the child’s parent(s)?
- Who else is in the household?
- Has the situation been discussed with the child’s GP?
- Have I updated myself on the child’s recent health history?
- Do I have knowledge of any siblings? May they be at risk of harm too?
- Is there a social worker already allocated? Have I discussed this referral with that social worker?
- Has the situation been discussed with a named nurse/senior colleague for safeguarding?
Prior to making a call, have the following available:
- the child’s health record
- a list of recent events
- the evidence triggering the call.
Section B: Aide-memoire to support efficient and appropriate telephone referrals of children who may be suffering, or are likely to suffer, significant harm.
- This is the health visitor (give name) for (give your area). I am calling about … (child’s name(s) and address).
- I am calling because I believe this child is at risk of significant harm.
- The parents are/aren’t aware of the referral.
Assessment and actions
- I have assessed the child personally (and done a CAF) and the specific concerns are … (provide specific factual evidence, ensuring the points in Section A are covered).
- Or: I fear for the child’s safety because … (provide specific facts – what you have seen, heard and/or been told and when you last saw the child and parents).
- A CAF has/hasn’t been followed.
- This is a change since I last saw him/her (give no. of) days/weeks/months ago.
- The child is now … (describe current condition and whereabouts).
- I have not been able to assess the child but I am concerned because … .
- I have … (actions taken to make the child safe).
- Specific family factors making this child at risk of significant harm are … (base on the Assessment of Need Framework and cover specific points in Section A).
- Additional factors creating vulnerability are … .
- Although not enough to make this child safe now, the strengths in the family situation are … .
- In line with Working together to safeguard children, NICE guidance and Section 17 and/or Section 47 of the Children
- Act I recommend that a specialist social care assessment is undertaken (urgently?).
- Other recommendations.
- Ask: Do you need me to do anything now?
Referral and recording
- I will follow up with a written referral and would appreciate it if you would get back to me as soon as you have decided your course of action.
- Exchange names and contact details with the person taking the referral.
- Now refer in writing as per these procedures and record details and time and outcomes of telephone referral.
(NB: The intention is to make reasons for referral factual and informative to assist the Children's Hub in taking appropriate action.)
If a child is at risk of immediate, significant harm, the priority remains to move them to a place of safety. The police have the powers to remove a child to a place of safety without parental consent.
The Safer Referral Form can be downloaded by clicking on the yellow icon 'Download Referral Form' at the top of this website.
The SAFER Referral Tool was developed from a communication toolkit called SBAR (Situation; Background; Assessment; Recommendation) that was originally created by the US Navy for use on nuclear submarines. It was adapted for use in healthcare by Dr M Leonard and colleagues from Kaiser Permanente, Colorado, USA.